Pediatric emergency care
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Pediatric emergency care · Oct 2012
Case ReportsBeneficial effects of levosimendan in infants with sepsis-associated cardiac dysfunction: report of 2 cases.
Although international guidelines for hemodynamic support of pediatric septic shock suggest considering the potent calcium sensitizer inodilator levosimendan as a second-line inotropic agent to treat cold hypodynamic shock resistant to catecholamines, clinical experience in septic infants is lacking. We report the beneficial effects of levosimendan infusion in 2 infants (39 and 64 days old) with low cardiac output septic shock (ejection fraction, 29% and 33%; fractional shortening, 10% and 16% respectively) refractory to volume replacement and to the catecholamines dopamine and dobutamine. ⋯ The only adverse effect was moderate hypotension in one infant, who reversed by adding norepinephrine to levosimendan. This clinical experience confirms the potential beneficial effects of levosimendan infusion to restore hemodynamics in infants with low cardiac output septic shock resistant to catecholamines.
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Pediatric emergency care · Oct 2012
Comparative StudyTransfer of simulated lumbar puncture training to the clinical setting.
To show that with a combination of evidence-based didactic and hands-on skill demonstration, pediatric interns will be able to correctly perform lumbar punctures (LPs) on neonates in the actual clinical setting. ⋯ A task trainer-based course improved the confidence and knowledge about an important pediatric procedure. This confidence and knowledge can translate to actual clinical practice. Further investigations are necessary to support this knowledge and skill translation.
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Pediatric emergency care · Oct 2012
Comparative StudyWho should be reading chest radiographs in the pediatric emergency department?
Pediatric emergency department chest radiographs are frequently interpreted by the pediatrician, and patient management is based on this interpretation. ⋯ Although the clinically significant discordant rate was relatively low, daily chest radiograph reassessment by pediatric radiologists in a joint meeting with pediatricians has an added value for patient safety, quality assurance, and mutual training.
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Pediatric emergency care · Oct 2012
Comparative StudyManagement of afebrile neonates with skin and soft tissue infections in the pediatric emergency department.
To describe the management of afebrile neonatal skin and soft tissue infections (SSTIs) in the pediatric emergency department (PED). ⋯ None of the neonates who had cultures drawn had serious bacterial infection. The SSTI subtype correlated with the extent of evaluation and dispositions. The findings of this study will help with management strategies for afebrile neonates with SSTIs in the PED.